电大护理专业药理学教学改革的思考

药理学是护理专业的一门重要基础课程,其教学内容和教学方法应如何改革以适应当代护理人才培养的需要,文章围绕护理教学改革目标,结合临床护理的实际需要,分析了护理专业药理学教学的现状及问题,并提出了改革的设想及措施.     

高流体静力压下脾静脉和大隐静脉管壁细胞凋亡变化

目的:观察不同静脉管壁在高流体静力压下细胞凋亡变化及机制。方法:收集高压性病脾静脉(DSV)与曲张大隐静脉(VGSV)标本,分别以正常脾静脉(SV)、正常大隐静脉(GSV)标本为对照。采用TUNEL、免疫荧光观察静脉管壁细胞凋亡情况,免疫组化检测凋亡相关蛋白Bax、Bcl-xl表达,电镜观察超微结构的变化。结果:与各自的对照比较,DSV和VGSV管壁(内膜和中膜)凋亡细胞比率明显降低(均P0.05);促凋亡蛋白Bax表达减少,抗凋亡蛋白Bcl-xl表达增加,Bax/Bcl-xl比值明显降低(均P0.05);DSV和VGSV的内皮细胞与平滑肌细胞出现线粒体嵴模糊、髓样变、核染色质边集。结论:不同的静脉管壁在高流体静力压下均存在相同的经线粒体通路细胞凋亡失调,这可能是导致相关疾病状态下静脉管壁扩张和增厚的重要机制。     

A clinical memory battery for screening for amnestic mild cognitive impairment in an elderly chinese population

Amnestic mild cognitive impairment (MCI) might be more likely to progress to Alzheimer’s disease than single non-memory MCI and multiple domain MCI. After excluding those who did not conform to the inclusion criteria of amnestic MCI or healthy controls, a neuropsychologic battery that included the Mini-Mental State Examination, Clinical Dementia Rating, Chinese version of the Montreal Cognitive Assessment, Instrumental Activities of Daily Living scale and Auditory Verbal Learning Test was performed on 150 amnestic MCI and 150 normal control patients. The Chinese version of the Montreal Cognitive Assessment was measured for its test-retest reliability, sensitivity and specificity. Blood was collected for apolipoprotein E (APOE) genotyping. Compared with the control group, the amnestic MCI group performed significantly worse on all neuropsychological tests, and non-APOE-??4 carriers in the amnestic MCI group performed better than APOE-??4 carriers in the amnestic MCI group. The set of neuropsychological tests in our study could distinguish amnestic MCI participants from normal elderly participants accurately. APOE did have a role in amnestic MCI patients, but the magnitude and mechanism of its influence are not fully understood.     

针药结合治疗干性坐骨神经痛37例临床疗效观察

目的观察火针淬刺结合中药治疗干性坐骨神经痛的疗效。方法将坐骨神经痛患者随机分为火针＋中药组（简称治疗组）37例和药物治疗组（简称对照组）32例,进行疗效对比。结果全部疗程结束1天后的疗效对比,治疗组显效率和有效率分别为78.4％和97.2％,对照组分别为43.8％和84.4％,治疗组均优于对照组,差异均有统计学意义（P〈0.01）。结论火针淬刺结合中药治疗对坐骨神经痛具有良好疗效。     

面神经炎发病和气象条件的关系

目的分析中国北方面神经炎患者与气象因素之间的相关性,初步探讨气象因素对面神经炎发病的影响。方法回顾性研究采集北京友谊医院神经内科及北京博爱医院神经内科2007年门诊和急诊收治的298例面神经炎患者的临床资料,并采集北京市气象台2007年逐月逐日平均气温、相对湿度、气压、风速、月平均气温、月平均相对湿度、月平均气压、月平均风速、风冷指数(WCF)等气象要素。分析气象因素与面神经炎发病之间的相关性。结果月平均相对湿度与面神经炎发病呈正相关(r=0.629,P=0.028),而月平均气温、平均气压、平均风速、WCF等未发现与面神经炎发病存在明显相关性(r=0.558,P=0.059;r=-0.509,P=0.091;r=-0.219,P=0.494;r=-0.562,P=0.057)。面神经炎发病并不存在季节性差异。结论月平均相对湿度可能是面神经炎发病的影响因素。     

神经肽Y对小神经胶质细胞活化状态和生成IL-1β的影响

目的探讨神经肽Y(NPY)对原代小神经胶质细胞生物活性及生成IL-1β的影响。方法培养的原代大鼠皮层小胶质细胞,将细胞分为Control组、LPS组、NPY+LPS组、NPY组和BIBP3226+NPY+LPS组,每组3个样本,培养各组细胞6h。经免疫细胞化学荧光染色后,显微镜下观察小胶质细胞的形态学变化。Elisa方法检测培养液中IL-1β蛋白含量,RT-PCR方法检测小胶质细胞中IL-1βm RNA表达水平。结果孵育各组小胶质细胞6h后,LPS组培养液中IL-1β蛋白的含量及细胞中IL-1βm RNA表达水平分别为(961.00±83.50)pg/m L和5.59±0.87,显著高于Control组的96.33±24.58 pg/m L和1.05±0.12(P0.05),小胶质细胞处于活化状态;LPS+NPY组IL-1β蛋白含量和m RNA表达水平分别为(411.33±55.00)pg/m L和1.93±0.45,与LPS组相比显著降低(P0.05),小胶质细胞活化水平降低;IBP3226+NPY+LPS组IL-1β蛋白含量和m RNA表达水平分别为(886.00±97.53)pg/m L和4.51±0.71,与LPS+NPY组相比显著增高(P0.05);LPS组和IBP3226+NPY+LPS组之间无统计学意义。NPY组与对照组无统计学意义。结论 NPY通过作用于NPY Y1受体降低小神经胶质细胞的生物活性,抑制其生成IL-1β。     

侧脑室脑膜瘤临床特点及显微外科治疗

目的探讨侧脑室内脑膜瘤临床特点及显微外科手术方法和注意事项。方法回顾分析51例脑室内脑膜瘤患者的临床、影像学表现及手术方法。结果本组病例82．3％存在头痛与视乳头水肿，17．6％表现为阵发性头痛加重，27．4％出现内囊、丘脑、视放射、Wemiche区受压局灶性神经功能障碍症状。采用颞间沟后部入路20例（39％），顶枕入路31例（61％）。肿瘤全切48例，新出现偏盲或视野缺损扩大6例，术后出现感觉性失语2例。3例肿瘤大部切除辅助伽马刀治疗。死亡3例（5．9％）。结论侧脑室内脑膜瘤症状以慢性颅内压增高为主，少数伴有阵发性头痛加重与局灶性神经功能缺陷。入路主要有经颞部与顶枕部两种，采用显微外科手术，注重微创原则，可得到较满意的治疗效果。     

高容量血液滤过对急重型弥散性脑肿胀治疗的临床研究

目的观察使用高容量血液滤过(血滤)对急重型弥散性脑肿胀治疗效果的临床研究。方法34例诊断为急重型弥散性脑肿胀、GCS评分为3~6分的病人被随机分成两组:治疗组(n=17)和对照组(n=17)。治疗组的病人入院后即给予高容量血液滤过治疗,置换液为3.0~4.0L/h,血流量为200~300m l/m in,时间为3~5d;对照组按普通常规治疗。两组病人均用血清神经元特异性烯醇酶连续监测1周,GCS在治疗后1、10、20d和GOS于3个月后进行检验、评估及统计。结果治疗组和对照组的血清NSE和GCS分别为(12.4±2.2)μg/L、(9.6±2.6)μg/L和(26.3±2.8)μg/L、(6.3±2.3)μg/L,两组有明显差异(P<0.01)。3个月后GOS评估,治疗组优于对照组,GOS 4~5级:治疗组7例(41.1%),对照组3例(17.7%);死亡:治疗组6例(35.3%),对照组9例(52.9%)。结论早期使用高容量血液滤过对急重型弥散性脑肿胀的治疗有明显疗效。     

One-step fabrication of soft calcium superhydrophobic surfaces by a simple electrodeposition process

A simple, one-step electrodeposition process was rapidly performed on a metal substrate to fabricate calcium superhydrophobic surfaces in an electrolyte containing calcium chloride (CaCl₂), myristic acid (CH₃(CH₂)₁₂COOH), and ethanol, which can avoid the intricate post-processing of surface treatment. The morphology and surface chemical compositions of the fabricated superhydrophobic surfaces were systematically examined by means of SEM, XRD, and FTIR, respectively. The results indicate that the deposited surfaces were mainly composed of calcium myristate, which can dramatically lower surface free energy. The shortest process for constructing a superhydrophobic surface is about 0.5 min, and the maximum contact angle of the as-prepared surfaces can reach as high as 166°, showing excellent superhydrophobicity. By adjusting the electrodeposition time, the structure of the cathodic surface transforms from the turfgrass structure, loose flower structures, larger and dense flower structures, secondary flower structures, and then into tertiary or more flower structures. The superhydrophobic surfaces showed excellent rebound performance with a high-speed camera. After a pressing force, their hardness increases, but the superhydrophobic performance is not weakened. Inversely, the bouncing performance is enhanced. This electrodeposition process offers a promising approach for large areas of superhydrophobic surfaces on conductive metals and strongly impacts the dynamics of water droplets.

We investigated a one-step method for calcium superhydrophobic surface preparation and researched the formation process of loose, flower-like microstructures. Also, we found that the pressing force strongly impacts the dynamics of water droplets.